Hemodialysis Patients on Proton Pump Inhibitors at Increased Risk for Hip Fractures

Published on October 2, 2018 by Sandy Liebhard

Proton pump inhibitors, including Nexium, Prilosec, and PrevAcid, may not be the best choice for patients undergoing hemodialysis, especially over the long-term.

How Was the Study Conducted?

According to research published in the latest edition of the Clinical Journal of the American Society of Nephrology, these individuals may be more likely to suffer hip fractures compared to those who use H2 blockers, another class of heart burn drugs that includes Zantac, Pepcid, and Tagamet, among others.

To reach their conclusions, the authors of the study identified 4,551 hemodialysis patients who had experienced hip fractures from 2009 to 2014. They compared these patients with 45,510 controls matched by date of their fracture.

An adjusted analysis of the data indicated that patients who had taken proton pump inhibitors in the 3 years preceding their fracture had a significant 19% increased chance of suffering a broken hip. There was no statistically-increase risk for broken hips among patients taking H2 blockers.

“The lack of an association with prior histamine-2 receptor antagonist use and the study patients’ hemodialysis-dependent status may suggest a more direct influence of PPIs on bone quality, as opposed to an effect on cation and nutrient stores,” the study authors concluded. “Thus, we recommend interval assessment of continued PPI use in patients dependent on hemodialysis who already experience substantial medication burden.”

Extended Proton Pump Inhibitor Use May be Harmful to Kidneys

Nexium, Prilosec, PrevAcid and other proton pump inhibitors are used by millions of people around the world to treat GERD and other digestive disorders caused by the excess production of stomach acid. In fact, some studies suggest that the drugs are overprescribed and used for far longer than current guidelines recommend.

Earlier studies have pointed to a range of proton pump inhibitor side effects associated with long-term use, including:

• Heart attacks
• Dementia
• Bone fractures
• Vitamin B deficiency
• Low magnesium levels
• Gastric cancer

A series of studies have also suggested that long-term proton pump inhibitor use may increase an individual’s risk for serious kidney complications, including kidney failure, chronic kidney disease, and acute kidney injury.

In December 2014, the labels for prescription proton pump inhibitors were updated to note that the medications had been linked to reports of acute interstitial nephritis, a serious kidney disorder that can progress to chronic kidney disease and kidney failure if it is not recognized and treated in a timely manner.

However, there are no other possible kidney side effects listed on the drugs’ labels.

Proton Pump Inhibitor Lawsuits

More than 2,300 proton pump inhibitor lawsuits have been consolidated in multidistrict litigation now underway in the U.S. District Court, District of New Jersey. All of the complaints were filed on behalf of individuals who allege that their long-term proton pump inhibitor use contributed to the development of kidney failure and other renal complications.

Among other things, plaintiffs claim that the drugs’ manufacturers have long concealed evidence linking proton pump inhibitors to serious kidney injuries and failed to provide the public with adequate notice of these risks. They further assert that these injuries could have been avoided had defendants warned doctors and patients that long-term use of their products could harm the kidneys.

In addition to New Jersey federal court, similar proton pump inhibitor lawsuits are pending in various state courts, including Delaware, Missouri, Pennsylvania, and Louisiana.